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Repatriation


myBenefits at a Glance


International Medical Plan

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Prescription Drug

Your drug plan covers 85% of the cost of most medications legally requiring a prescription to a maximum of $3,000 per benefit year.Your drug plan covers up to $8.00 of the dispensing fee.

Select Savings Opportunity : In partnership with MacKinnons Pharmasave, students will be able to access 100% coverage for the dispensing fee portion of a prescription drug claim at both the Bloomfield Center and Main Street locations.

Pharmasave Convenience for U
5555 Union Place, STFXU
Antigonish, NS B2G 2W5

MacKinnons Pharmasave
243 Main Street
Antigonish, NS B2G 2C1
Phone: (902) 863-2008 | Fax: (902) 863-0494


The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

IMPORTANT! Advise your doctor and pharmacist that you are on the NASA Formulary with a generic rider
.

The NASA Formulary is a specific list of drugs that are eligible for reimbursement under your drug benefit. Formularies are developed to ensure that prescription drugs are available on a cost-effective basis. It covers approximately 85% of the most frequently prescribed drugs. Formularies are reviewed regularly and as a result, updates are made on an ongoing basi

Exception Process: In the event that the drugs covered by the Formulary are not effective in treating the condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug listed on the Formulary. An exception drug request form is available below or from your STFXSU Student Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your STFXSU Student Benefits Plan Office or can be faxed directly to the insurance company.

Request for Coverage of Exception Status Drug form

Vision

Reimbursed at 100% to maximum of $80 every 24 months for eye exam, and 100% to a maximum of $200 for glasses or contact lenses.

Dental

Payment of dental benefits is based on the General Practitioners Dental Association suggested fee guide or the Insurance Reimbursement Rate set by the Canadian Life and Health Insurance Association Inc. (CLHIA) when a fee guide is not available. For services provided by a dental specialist, payment is based upon the General Practitioners Dental Association suggested fee guide.

Alternate Benefit - When there are two or more courses of treatment available to adequately correct a dental condition, reimbursement may be based on the cost of the least expensive treatment, which provides adequate care to the Insured.

IMPORTANT! Please submit a pre-determination/pre-authorization to the insurance carrier prior to treatment of specialist services and any treatment plan exceeding $500.

Plan maximum is $900 per benefit year.



Diagnostic & Preventative
Your plan covers 90% of diagnostic and preventative procedures including
• Polishing or cleaning teeth, 2 units per benefit year
• Scaling, 2 units per benefit year, 6 additional units covered at 80%
• Recall, initial or complete examination, once per benefit year
• full mouth series of x-rays once in a 36 month period (not eligible for dependents under 12)
• Periapical, up to 16 films in a 36 month period.
• Bitewings, not more than 4 films per benefit year
• panoramic, 1 in any period of 36 months
• fluoride, 1 treatments per benefit year for dependants age 16 or younger.
• Oral hygiene instruction, 1 treatment per lifetime
• pit and fissure sealants, under 16 years of age, 1 molar in a period of 36 months
• space maintainers and maintenance, 1 per benefit year
• anaesthesia, eligible when done in conjunction with a covered dental procedure
Minor Restorative
Your plan covers 80% for services associated with dental health restoration, including:
• sedative, silver and white fillings(All restoration done to the same tooth will be covered as a single visit to the dentist)
Oral Surgery
Your plan covers 80% for services associated oral surgery, including:
• Residual Root Removal
• Extractions
• Alveoloplasty, Gingivoplasty, Stomatoplasty, Vestibuloplasty
• Surgical Excision
• Surgical Incision
• Fractures
• Frenectomy
• Post-Surgical care
Endodontic
Your plan covers 80% for endodontic services including:
• Pulpotomy
• root canal therapy (once per tooth)
Major Restorative
Your plan covers 80% of major restorative services including:
• Pins
• Crowns
• Posts

Tutorial

Eligible for a maximum of $15 per hour to a maximum of $1,000 per benefit year for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.

*Applicable to the Student only. Family members are not eligible for reimbursement of Tutorial benefits.

Travel Insurance

Emergency Out of Country Travel Insurance
Your plan covers 100% up to a maximum of $5,000,000 per incident of medical expenses incurred as a result of a medical emergency arising while you are traveling outside Canada for vacation, business or education purposes.

If travel is required for a course of study, you can be covered for up to 365 days.

Students and their dependants are no longer covered once they reach the age of 65.

To qualify for benefits, you must be covered by the government health plan in your home province or enrolled on the Students' Union International Student Medical Plan. For additional details on this benefit download your Travel Assist Brochure.

Personal Health Risk Assessment

The Personal Health Risk Assessment can be used to create a health profile, build an action plan to support your health and wellness needs and track progress.
Watch a short video about Personal Health Risk Assessment.

Exclusions, Limitations and Restrictions


Supplemental Health




Ambulance
Your plan covers of 100% of the reasonable and customary charges per occurrence for licensed ground ambulance or emergency air service that transports the patient to the nearest hospital equipped to provide the required treatment when the physical condition of the patient prevents the use of another means of transportation. If the patient requires the services of a registered nurse during the flight, the services and return airfare for a registered nurse are covered. Limited to one trip per benefit year.

Practitioners
The services of the following practitioners are covered at 100% for $40 per visit to a maximum of $300 based on reasonable and customary charges, per practitioner, per benefit year.
- Acupuncture
- Podiatrist^/Chiropodist
- Chiropractor^
- Massage Therapist *
- Dietitian
- Osteopath^
- Physiotherapist / Athletic Therapist *
- Speech Therapist

The services of the following practitioners are covered at 100% to an overall plan maximum of $900 based on reasonable and customary charges, per benefit year.
- Psychologist or Registered Social Worker

The services of the following practitioners are covered at 100% for $75 per visit to a maximum of $300 based on reasonable and customary charges, per practitioner, per benefit year.
- Naturopathic Consultations*

*physician’s prescription/referral required for indicated services.
^If an X-ray is recommended, an additional $25 is covered towards this expense.

Medical Services & Supplies
It is recommended that an application for pre-approval be submitted to the insurer for any item that would be claimed under the Medical Services & Supplies benefit.
Your plan covers a maximum of $2000 per student benefit year for medical equipment and supplies.

Medical Equipment
Your plan covers a maximum of $2000 per student benefit year for eligible medical equipment when prescribed by a physician. Eligible durable equipment includes, but is not limited to, items such as:

• wheelchairs (repairs, $250 per lifetime);
• respiratory equipment, including oxygen, maximum $1,500 per student year
• contact lenses/glasses following cataract surgery limit 1 pair per lifetime
• canes, crutches, walkers, casts, splints catheters
• compression stockings limit 2 pairs per student year
• blood glucose monitor, maximum $500 per student year
• insulin pumps, maximum $500 per lifetime
• Intra-Uterine Devices with no medicinal content limit1 per student year
• aero chamber limit 1 per student year
• custom-made rigid or semi-rigid braces (not for athletic use) for back, neck, arm or leg, maximum $1,000 per lifetime, per condition
• non-dental prostheses such as artificial limbs and eyes; including replacement if required due to a change in physical condition
• Hearing aids covered at 50% up to $500 every five years

Braces, Crutches, Splints, Trusses
Your plan covers 80% of reasonable and customary charges when prescribed by a physician and are not solely for athletic use for braces, crutches, splints, and trusses.

Prosthesis
Your plan covers 80% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.

Orthopaedics*
Your plan covers 80% up to a maximum of $150 per benefit year for custom-fitted orthopaedic shoes, repairs and modifications when required for the correction of deformity of the bones and muscles. Provided the orthopaedics are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor.

*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Great-West Life to ensure that the guidelines set out by Great-West Life for the payment of Orthopaedics are met and to confirm that your claim would be eligible.

Dental Accident
IMPORTANT! Dental Accident Pre-determination: An estimate for all dental accident services MUST be submitted to the health plan insurer. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.

The plan covers 100% of the cost of the services of a dental surgeon, limited to the fees provided in the current General Practitioners fee guide, including dental prosthesis, required for the treatment of a fractured jaw or accidental injuries to natural teeth or jaw if caused by external, violent and accidental means. Services must be started within 90 days of accident and completed within 12 months of the accident. Dental Accident benefits are payable through the Health plan and limited to $1,000 per accident.